# Apathy in patients with Neuromyelitis Optica Spectrum Disorder

## TL;DR

This study finds that apathy is common in neuromyelitis optica spectrum disorder patients and is linked to depression and lower quality of life.

## Contribution

First investigation of apathy in neuromyelitis optica spectrum disorder (NMOSD) patients using the Apathy Evaluation Scale.

## Key findings

- 40.9% of NMOSD patients showed clinically significant apathy with a mean AES-S score of 36.7 ± 8.3.
- Apathy was strongly correlated with depression, fatigue, and lower quality of life in NMOSD patients.
- Depression was identified as a significant independent factor contributing to apathy in these patients.

## Abstract

Apathy is a common neuropsychiatric complication of neurological diseases, but it has not been investigated in patients with neuromyelitis optica spectrum disorders (NMOSD) until now.

We enrolled 66 patients diagnosed with NMOSD and assessed apathy using the self-reported version of the Apathy Evaluation Scale (AES-S). All the patients also completed the investigations composed of demographic data, disease characteristics, and composite evaluations of life status, including anxiety/depression, fatigue, sleep, and quality of life. Further statistical analysis proceeded.

The mean AES-S score was 36.7 ± 8.3, with 40.9% of patients exhibiting clinically significant apathy (cutoff score: 36). Correlation analysis revealed that higher AES-S scores were significantly correlated with lower education attainment (p = 0.002), more number of attacks (p = 0.008), longer disease duration (p = 0.004), higher disability (p = 0.03), severer anxiety (p < 0.001), severer depression (p < 0.001), severer fatigue (p < 0.001), and severer sleep disturbances (p = 0.001). Depression was revealed to be a significant independent factor of apathy (P < 0.001). The subscales of AES-S and its correlated factors were also analyzed. Further analysis showed that the AES-S score was negatively correlated with the total score of the quality of life scale and all the sub-dimensions' scores (P < 0.05).

These results suggest that apathy is a common neuropsychiatric complication in patients with NMOSD and is closely related to their quality of life. The apathy of NMOSD correlated with various physiological and psychological changes, especially depression. These findings might help us identify patients with a high risk of apathy, highlighting the importance of evaluating and managing apathy is of great significance for improving the quality of life in NMOSD patients.